Saturday, 25 June 2016

The last few days of the Brexit drama should be a revealing experience for thinking Indians who care for the quality of our polity, particularly of its leadership. Just reflect: could a Brexit type event have ever taken place in India without ripping the country apart, large scale destruction of public and private property, violent deaths and politicians behaving in the manner of gutter rats ? Look back on Telengana, the Jat agitation and you will see what I mean. For the simple fact is that though we may claim to have modelled our democracy on the Westminster prototype, in actual practice we have none of its essential conditions: leadership. trust in the citizens and a responsible political system.

There are many admirable things about Brexit and what it tells us about that tiny nation. One, it trusts its citizens to make the right choices and on seminal issues the govt. of the day will not ram its own views down their collective throats. This was Britain's third referendum: in 1975 it decided to join Europe, last year it decided that Scotland will remain part of it, and now it has reversed that first decision. Two, the govt. and the nation at large accepts these decisions in good grace, without recriminations, judicial interventions, money exchanging hands, or public violence. In India a PIL in some court would ensure that the decision is stayed for the next decade or an uproar in Parliament would lock down its functioning ad infinitum.

Three ( and there's a reason why I am devoting a separate para to this): if Brexit demonstrated something, it is what true leadership is about. David Cameron publicly proclaimed his support for remaining within the EU but still allowed his Ministers and party members to vote according to their own wishes: at least four of his Ministers announced their support for the LEAVE camp. He need not have taken a stand on the issue ( after all, his own party was divided on it) or even have held a referendum- but he felt that the question deserved an answer, and that as Prime Minister he owed it to the nation to lead from the front by making his own position clear and unambiguous. He still commands a majority in Parliament, enjoys the confidence of his party as its leader, and yet decided on Friday to step down as Prime Minister- NOT because he lost the referendum ( the hollow cliche in our country is " owning moral responsibility") but because he felt that he " was not the man to steer the ship to new destinations". Having supported REMAIN he felt he could not be an honest broker in negotiating Britain's exit from the EU, and so must hand over the baton to someone more in sync with the LEAVE ideology.

Cameron has paid the price for being a moral. honest and outstanding leader, and a man of honour. Without wishing to diminish the thought, one can't help but wonder: would ANY Indian Prime Minister of today come even close to displaying this kind of leadership values and principles? Does the Indian DNA have a mutant gene that prevents our politicians ( I except no one on today's stage) from becoming leaders? Food for thought as you wait for the monsoon to arrive.

* * * *

It is an old adage that if you want to see how small a man is give him a big job. The living proof of this truism is none other than Mr. Javadekar, the Union Minister for Environment and Forests who has made it his mission in life to destroy what remains of our environment, wildlife and forests. His latest effort in this direction is the liberal permission he has granted to four states to cull wild animals.

Culling is an accepted methodology for controlling population of wild animals if the same is becoming unsustainable or threatening humans. But it has to be done in a scientific ( not political or populist) manner and has to be preceded by proper surveys to determine whether the overall population of a particular species is actually growing in absolute numbers, whether the visible " excess" is due to loss of habitat, human interventions or natural increase, what is the nature of the " danger" they pose, and whether any reduction in prey species would lead to narrowing of the prey base for predators and consequent increase in the intensity of man-animal conflicts. No such surveys were ever conducted in any of the states- Himachal, Uttarakhand, Bihar, Madhya Pradesh- where the Ministry has allowed the culling of nilgai, monkeys and wild boar. ( A proposal is pending with Mr. Javadekar to permit the killing of peacocks- the national bird, no less- in Goa !). Bihar simply submitted a two page report, on the basis of which hundreds of animals have been slaughtered by professional shooters- I have no doubt that it must be party time for Bihar foresters these days, what with so much prime meat available free. With the country losing 600,000 hectares of original, prime forest every year there can be little doubt that the cause of the problem is loss of habitat, forcing wild animals to stray into agricultural fields, but the Ministry will not even look at this possibility.

Secondly, culling is not the only solution: in fact it should be the last. Animal population control measures also include translocation and the manipulation of reproductive ability- these should have been resorted to first if at all the numbers were indeed excessive( which has not yet been established). The latter, in fact, has already been tried in Himachal for rhesus monkeys, with some success. In 2007-08 the HP Forest Department started setting up monkey sterilisation centers across the state, of which there are eight now. This was after trying translocation which was an unqualified failure- monkeys are too smart to be translocated: it is easier to translocate Kashmiri pandits ! According to a report I read recently, so far approx. 100,000 monkeys have been sterilised ( 25% of the total population) and the latest wild life census indicates that their population has declined by 18000 or 4.5%. That is remarkably good progress and certainly much better than the numbers for the one species which should be culled first- homo sapiens! According to the Human Population Division of the UN, human population has been increasing relentlessly since the Black Death of 1400 AD. It is 7.5 billion today and is expected to grow to anywhere between 9.5 billion and 13.5 billion by 2050. The planet has already exceeded its carrying capacity of 4.5 to 6 billion a long way back. Talk of double standards.

There IS a monkey problem in Shimla- but we are to blame for it exclusively, not Kipling's simians. We feed the monkeys at Jakhoo's Hanuman mandir ( we have even set up an atrociously ugly statue of Hanuman there, which, according to me, looks more like Shakti Kapoor than the monkey God); tourists are seen feeding them all over the Mall and the Ridge, and the incompetence of the Municipal Corporation ensures that the garbage bins are never cleaned and thus provide regular banquets for the apes throughout the year. Now, if you were a starving ape in Sainj valley whose forests had been replaced by concrete dams and power houses, would you still linger there, or would you take the first bus to Shimla ? Even a Bihar School Board topper would have no difficulty in figuring out the correct answer.

Unnecessary, short-sighted human interventions are the real reason why wild animals stray into farmers' fields and cause damage to their crops. But instead of exploring the reasons and adopting scientific measures the govt. as usual opts for the quick-fix route: kill the animals. There are non-zoological solutions too which can also be considered: include crop damage by wild animals as one of the damages covered under the Crop Insurance Scheme, or have a separate scheme for this. Most state govts. already compensate farmers and shepherds for loss of live stock due to predator attacks; add crop damage to this. Surely a state govt. can spend a few crores of rupees on this in order to preserve its dwindling wild life? If necessary, build in a corpus fund for this in the environmental charges levied on projects which require diversion of forest land. Be innovative, Mr. Javadekar, not murderous.

And lest you are overly impressed with your Cabinet status, heed the following:

Wednesday, 15 June 2016

I have a feeling that many would agree with me that the medical profession has now become the most venal and unscrupulous of professions in India. Patients in All hospitals- govt. or private- are like cattle being led to slaughter- and in private hospitals they are being made to pay for it too! Each of us knows a horror story or two but two recent cases posted on social media plumb new depths in depravity and commercialisation of health care. Both relate to the much vaunted Medanta Medicity; I give below the links to them and would advise all who are planning to go to Medanta to first read them:

Government hospitals are bad enough, treating patients like cattle, but the burgeoning new crop of private hospitals and nursing homes are like Dante's Hell: " Abandon Hope, All Ye Who Enter Here."The arrogance of the Doctors there is matched only by their rapacious skill in extracting your life savings through unnecessary " consultations", superfluous " investigations" and extended stays in exorbitantly priced ICUs, sometimes even when the patient is dead! They will not deign to explain anything to you. Sometime back my son was being treated at a leading hospital in Delhi and the urologist prescribed a particular test which cost ten thousand rupees. He had undergone this same test just three months ago and the results were fine, so I asked the Doctor the need for repeating it so soon. His haughty response was that I wouldn't understand since I did not have an MBBS degree! I politely disagreed, pointing out that I had an MA and a diploma in Management, had taught in a University for two years and then spent 35 years in govt. service, had published a book and written more than one hundred articles: in other words, I was reasonably literate and not as stupid as I looked, and therefore he could try explaining to me the answer to my query. His response: " I am a very busy man, I don't have the time. I'll ask my nurse to explain it to you"! I gently reminded him that I had just paid Rs. 1200/ for his time and that if he didn't have it ( the time) he could refund my money and I would be happy to go elsewhere. The session ended with a joint decision that the test was not necessary. I have not gone to that Doctor again and my son is none the worse off for not having gone through the test,

But that is no cure, because most other doctors would behave exactly the same way.

How have things come to such a sorry pass? Here are a few reasons:

One, the govt. has created space for the rapacious private sector by completing abdicating its responsibility to provide good quality health care to its citizens. India spends only 1.3% of its GDP on health, and 80% of that is spent by the private sector. The global average is 6.5%. Our per capita spend is US$ 39, as against 203 and 483 for China and Brazil, respectively . The govt. has no money for improving public health infrastructure even as it doles out thousands of crores to subsidize Air- India and publicise its own achievements.The deplorable state of public health services is reflected further in the following figures: bed intensity is 1.3 beds per thousand pop. against the WHO norm of 3.5; there are only 0.7 doctors and 1.71 nurses per thousand population, and to reach the WHO norm we need an additional 1.5 million doctors and 2.4 million nurses( we produce only 50000 doctors every year!), and 1.8 million beds. This requires an investment of Rupees 1.65 trillion, about 2% of GDP over and above the current provisions. The imbalance between urban and rural areas is even more telling: 70% of all available beds are in the top 20 cities!

Two. This historical neglect has led to a warped and unhealthy surge in private hospitals whose sole aim is to make money. Health care has thus become corporatised and hospitals are no longer run by doctors but by management graduates who are more concerned about the bottom line than the oxygen line. Stories are now emerging from whistle blowers about how doctors are expected to " convert" 40% of their OPD patients into in-patients, how they are forced to generate a minimum revenue for the hospital every month, how revenues from everything- medicines, lab tests,ultra sounds, MRIs- are shared with the prescribing doctor, how unnecessary operations and procedures are carried out simply to inflate bills. Health is no longer about CARE, it is now about BUSINESS with all the attendent decline in human values that goes with commerce. Even that would be acceptable if the poor patient at least received the succour he is paying for: as the two Medanta stories indicate, however, even that is not forthcoming. How deep the rot has set in is best illustrated by the Delhi govt's order last week imposing a fine of Rupees 600 crores ( US $ 100 million) on five Delhi private hospitals for not providing free treatment/ hospital beds to EWS patients as they are required to do as a condition of getting land at concessional rates. It is to Mr. Kejriwal's credit that he has taken this bold step. The order will of course be challenged in the courts. The govt. should insist that, while the matter is being heard, 50% of the revenue of these five hospitals should go into an escrow account, to be accessed/drawn only on the conclusion of the case: this will ensure that the fine amount is secure( not fly away like Mallya's millions), and also that the hospitals don't spin out the litigation endlessly.

Three. There is no regulatory framework to discipline or punish erring doctors and negligent hospitals. The MCI ( Medical Council of India) is supposed to do so but rarely, if ever, does so. It has become such a moribund and corrupt body that the Supreme Court was recently forced to appoint a three member panel, headed by Justice( Retd.) Lodha to oversee its functioning. The aggrieved patient, if he survives, has no option but to take recourse to the courts where he rarely gets justice, given the absence of a strong law on Torts and the infamous delays that mark our judicial system. Sooner or later he runs out of either patience, or money or life itself and the corporates win everytime. There is an urgent need to legislate an independent Regulator for the Health sector, with powers to fine, punish, disqualify, award compensation and cancel licences. After all, if there can be regulators for telecom and real estate ( which are not life and death issues), then surely there is a greater need to have a similar statutory authority for hospitals and doctors. The MCI's role should be downgraded to just registration of doctors and over-seeing medical education.

Finally, medical education in India is too narrow and tunnel-visioned. Medicine is not just a science, it is also an art that encompasses humanities: the art of communicating with patients, the understanding of his or her psychological state of mind, empathy, the ability to comfort, if not cure, compassion. All these humane traits are missing in medical education, leading to the complete disregard of moral and ethical values. The humble GP ( General Practitioner) of my childhood has sadly become extinct, but he epitomised what a real doctor is expected to be- a friend of the family, available at all hours, treating more with love than medicines, a soothing presence at one's bedside. Today's doctors have the bed side manners and behaviour of a chamber pot. It is the lack of these humane and compassionate elements in modern medical education that partly explains why doctors today are the uncaring, for-profit robots that most patients perceive them to be.

I sometimes wonder-- who is the sick one here: the doctor or the patient ?

* * * *

English is a wonderful language and I am always fascinated by its endless possibilities- its words can be turned and twisted to convey a myriad of meanings: changing just one letter in a word can confer an entirely new meaning to it and open up a whole new vista of humour and wit. Here are a few puns I seem to have come up with during my deepest moments of unemployment:

Saturday, 11 June 2016

Last week's mayhem at Mathura, which resulted in the murder of two police officers ( and killing of twenty seven other " satyagrahis") should have surprised no one who has been following the steady debasement of our polity, administration and societal mores. There are many disturbing aspects to this display of mob violence ( which I am sure a conveniently appointed inquiry commission will NOT go into), but I would like to focus on perhaps the most alarming dimension of this lawlessness: the frightening deterioration in the professionalism of the administration, specifically the police forces of this country. No one could have failed to notice the steady, consistent and progressive decline in the ability of our police forces( no state excepted) to maintain order and enforce the law of the land.

It is very clear now that the Mathura incident occurred only because the district administration had completely abdicated its role and authority over the 270 acres that comprised the Jawahar Park, taken over by a rag tag bunch of land grabbers masquerading as a loony sect. They could not have moved in overnight: the creeping encroachment was obvious but no one stopped them. ( The DM wrote letters to the Chief Secretary. Why? He had the powers to evict them, but instead he chose to create an alibi which will now stand him in good stead). The goons did not allow govt. officers, not even the City Magistrate, to enter the Park, beat up a police Inspector, terrorised the Horticulture department officials inside, chopped down 3000 trees to build their huts. They continued to do all this for almost three years but no steps were taken to evict them: only notices were sent( more alibis?). The Allahabad High Court in June 2015 ordered their eviction: even this order was not implemented for one year.

The more frightening part. These criminals collected fire arms, grenades, crude bombs, gas cylinders to be used as IEDs. They built machans on trees ( from which vantage point they appear to have shot down one police officer, the SP was reportedly beaten to death). Even a Bihar student ( he doesn't have to be a " topper") would have guessed that they were preparing for a major confrontation. Why couldn't the administration and the police ?

The answer is frighteningly simple: they KNEW but they had either abdicated their powers in favour of politicians, or they lacked the professionalism to read the signals and take counter action. Or both. Before you take on an enemy you must try to know everything about him- the Mathura police had never bothered to do so and paid for it with the tragic loss of two of their own.

But here is what should trouble all right thinking Indians: Mathura is not an isolated case or an aberration- it is only the latest in a series of similar incidents which point towards an almost total collapse of the police forces in the states: the Muzzafarnagar communal riots, the most recent Jat agitation in Haryana, the beating up of students and journalists outside the Patiala House courts in the JNU case, the prolonged showdown with the followers of sect leader Rampal Dass in Hisar in 2014 , the unchecked rioting in Malda. All these challenges to the law had three things in common: the catalyst for all of them were politicians and political parties, the police and the administration either had no clue as to their intentions or had adequate foreknowledge of them but did nothing to prevent the incidents, and when they did belatedly act they were hopelessly unprepared. These last two commonalities are prime indicators of the progressive disintegration of the country's police apparatus.

Effective intelligence gathering lies at the heart of effective policing, but our forces have either completely given up on this or confine themselves to gathering only " political" intelligence that serves only the interests of their political masters of the day. Nothing else can explain Malda and Mathura and the manner in which the authorities were taken by surprise at the sheer scale of the violence in both cases.

Even more alarming, however, is that, increasingly, the police do not act to prevent violence: prime examples of this are the Jat goondaism in Haryana, the Patiala House lawlessness in Delhi and the communal carnage in Muzzafarnagar. It is incomprehensible that a force which is mandated by law to prevent a crime can stand by idly and watch as public property is destroyed and citizens assaulted.

The nadir of this professional decay is achieved when the police, when finally forced to act, do so in the most incompetent manner: without essential intelligence inputs, unprepared with equipment, lacking any coordinated planning or clear strategy, depending solely on numbers. This results either in excessive use of force or casualties to their own members. It is this abysmal lack of professionalism that killed SP Dwivedi and Inspector Yadav in Mathura, not the followers of Ramvriksh Yadav. And if any further proof of this is needed, it is now provided by eyewitness reports now emerging that Dwivedi was DESERTED by his own troops when he was being attacked! They could have saved him- had they acted like professional and trained policemen.

These two deaths are a metaphor for the precarious and diseased state of our police forces, which bodes ill for the country. A uniformed force which follows political directions rather than legal mandates, attaches no importance to training, neglects its intelligence gathering functions, relies on numbers and brute force rather than SOPs, does no planning for action and goes in unprepared- this is a recipe for disaster.

The Indian police is fast losing its professionalism, and appointing the likes of Mr. Bassi, the retired Delhi police Commissioner who famously refused to take action against criminals because of the " risk of collateral damage", as a UPSC member is one reason why. But responsible members of the force need to introspect whether the time has now come for them to do something to stop this slide, if not for the sake of the country then in their own interests. After every such incident it is inevitably the officers who are made the scapegoats and made to pay the price- never has a politician been held culpable, and the same scenario is playing out post Mathura. But the stakes have just got higher - they are now paying with their lives. Is political pandering, a favourable transfer and a post retirement sinecure worth the risk?

* * * *
We Indians like nothing better than a good bargain, and in keeping with our obsession we now appear to have got two Prime Ministers for the price of one!- Mr. Modi ( Abroad) and Mr. Modi( Domestic).
The Modi( Abroad) is most certainly now an international statesman: his speech at the US Congress the other day hit all the right notes: terror, environment and climate control, the India- US connect, the values of freedom and liberty, the tolerance of diversity, economic parternership. The quotes( Vivekananda, Martin Luther Singh, Walt Whitman) were bang on. Even the humour was appropriate and engaging and he deserved every one of the eight standing ovations. I have rarely heard a more stirring oration by anyone, Indian or otherwise.
But this was not the Mr. Modi( Domestic). Back at home he is an entirely different person. On terror he doesn't appear to have any consistent policy on Pakistan, calling off talks one day and dropping in on Nawaz Sharif in Lahore the next day, holding the ISI responsible for the Pathankot attack but inviting the ISI to the crime scene the next. On environment he allows Mr. Javadekar to run amock. slaughtering wild animals under the guise of "vermin", persisting with the disastrous river linking scheme without proper environmental impact studies, nibbling away at National Parks and Tiger reserves, denotifying 10000 sq. kms. of the Western Ghats from the Eco Sensitive Zone. On diversity he will do nothing to stop the RSS and related cohorts from trying to make India a uni-polar Hindu rashtra; on federalism he is constantly on the stump destabilising and dislodging state govts headed by other political parties; on freedom of thought and action he is doing everything possible to curb dissent, ban NGOs, censor films,police the net. On liberty and tolerance, he will not utter a word to condemn victimisation of minorities by lumpen bigots associated with his party.Will the real Mr. Modi stand up ?

Sunday, 5 June 2016

Politicians are opportunistic creatures, adept at hunting with the hounds and running with the hares. But over the last two weeks Mr. JP Nadda, the union Health Minister, has improved over that- he is now hunting with the hares and running with the hounds. The reference is to the shenanigans over the NEET( National Entrance-cum-Eligibility Test) for Medical colleges, recently mandated as compulsory ( by the Supreme Court) for admissions to all medical seats, govt. or private.
This was the first essential step to cleansing the augean stables that medical education in India has become, reeking with corruption, capitation fees, dubious " management quotas", lack of uniform standards, multiplicity of admission tests for harassed students, patronage and rent seeking. This putrescence had been given the stamp of approval by the Supreme Court itself, unfortunately, in a perplexing 2012 judgement by the then Chief Justice. By setting aside this dubious order last month and restoring NEET the Court has given a glimmer of hope that the rot would be stemmed.
Enter Mr. Nadda. He defends and supports NEET in court but comes out and issues an ordinance on May 24th, deferring it for a year for all govt. colleges and govt. seats in private colleges! This is where he doesn't know who to run with and who to hunt with. We just don't know whose interests he has at heart: the long suffering students and the unfortunate patients long exposed to inferior doctors churned out by the present system, or the incompetent and sub-standard State Boards and the state politicians who can always " manage" the state quota seats?
Mr. Nadda has only muddied the waters further, and made confusion worse confounded. NEET I has already been held on 1st May 2016 when 650000 candidates took this exam; what is their status now that NEET has been partially deferred? The ordinance is sought to be justified by stating that the candidates did not have enough time/ notice to prepare for it; that NEET will be based on the CBSE syllabus whereas the existing admission Exams were based on state Boards syllabus, as such the latter will be at a disadvantage compared to those from CBSE schools. These arguments are self- contradictory. Since 650000 students have already taken NEET ( many of them not being students of the CBSE syllabus) will they not be at a disadvantage now compared to those who will now be allowed to take the exam conducted by the state Boards? Secondly, by creating a distinction between Govt. Medical Colleges and Private Medical Colleges and making NEET applicable only to the latter, Mr. Nadda has created two parallel streams of examination, which is not only illogical and discriminatory but also unfair. And finally, doesn't he realise that the whole idea of NEET is to have a uniform standard for testing candidates ? By opposing NEET precisely on this ground he is succumbing to pressure from states who have all ten crooked fingers in this pie.
Mr. Nadda may think he has got breathing space for one year at least. These issues will still be there next year also. He has only deferred the day of reckoning till the Supreme Court takes up hearing of the plea challenging the ordinance. He has betrayed the trust of the Court- The specious arguments he is now making should have been presented to the Supreme Court when the matter was being heard there. Not only did he not do so, he actually supported NEET ! He may yet discover that the ordinance route was an unprincipled one and he will ultimately end up pleasing neither the hares nor the hounds.

* * * *

Strange indeed are the ways of God, and stranger are the ways of governments! At a time when we are being fed poisons in everything we eat, drink and breathe ( the latest being our daily BREAD, as per a recent report of the Center for Science and Environment), instead of doing something tangible about this the govt. has instead decided to launch an all-out war against a humble condom !
It appears that Durex has been marketing a brand of condoms called Extended Pleasure and Kohinoor Extra Time ( how subtle can one get ?) for the last 15 years; their USP is that, coated with a mild anaesthetic drug known as Benzocaine, they delay the onset of climax and hence offer more value for money. Apparently, since this is a govt. that wants to fast track everything and frowns on any kind of delay, it has ordered Durex to stop production and sale of these brands, on the ground that it had never approved this drug as a coating on this prophylactic. The Delhi High Court has benzocained this order, i.e. stayed it. The case will no doubt be decided after due intercourse is held between the parties and many adjournments ( termed Extra Time in this case) are granted. But to my mind this case raises a couple of interesting questions. One, does a stay order on the use of a condom amount to "coitus interruptus" ? And two, if chaps who have been using this addictive contraption for many years are suddenly denied its use, will they not develop withdrawal symptoms? And finally, should the govt. not also verify whether the fruit flavoured condoms ( favoured by vegans, I'm told) have the approval of the Food Standards and Safety Authority of India? After all, as the old adage goes, one man's fruit may be another man's condom.
Weighty questions which I have no doubt the Court will strip bare eventually: the culmination, however, could take a little time, given the nature of the subject.

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Very few of us would have heard of Phyllis Diller ( 1917-2012). She was an actress-comedian who created the " Dillerism"- a brief, pithy aphorism remarkable for its subtle wit, association of ideas and earthy wisdom. I reproduce below some of my favourites, sent to me by a friend from the United States:

* Whatever you may look like, marry a man your age.
As your beauty fades, so will his eyesight.
* The reason women don't play football is because 11 of them would never wear the same outfit in public.
* My photographs don't do me justice- they look just like me.
* I admit, I have a tremendous sex drive; my boyfriend lives 40 miles away.
* You know you're old if they've discontinued your blood type.
* A bachelor is a guy who never made the same mistake once.

This is real humour and wit- it makes you chuckle silently and smile to yourself, not laugh out loud. That would be All India Bakchod, burlesque masquerading as humour. Give me a Dillerism anyday.